Healthcare Provider Details

I. General information

NPI: 1083981310
Provider Name (Legal Business Name): CYNTHIA ASHLEY REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2011
Last Update Date: 12/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 DELAWARE AVE
ALBANY NY
12202-1301
US

IV. Provider business mailing address

45 DELAWARE AVE
ALBANY NY
12202-1301
US

V. Phone/Fax

Practice location:
  • Phone: 518-475-6482
  • Fax:
Mailing address:
  • Phone: 518-475-6482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number309-891-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number309-891-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: